重症颅脑损伤患者早期肠内营养应用临床观察

Clinical analysis of early enteral nutrition support in patients with severe craniocerebral injury

目的探讨神经外科重症颅脑损伤患者早期肠内营养支持的意义和方式。方法将62例重症颅脑外伤昏迷患者随机分为早期肠内营养支持治疗组32例和静脉营养组30例,观察比较入院时及治疗2周后各项营养指标。结果治疗2周后,肠内营养组和静脉营养组患者血清总蛋白(TP)、血清白蛋白(ALB)、血清前白蛋白(PALB)均较入院时增高,差异有统计学意义(P<0.05或P<0.01)。2组间比较,治疗后的TP、ALB、PALB在肠内营养组的改善情况均优于静脉营养组,差异有统计学意义(P<0.01)。静脉营养组并发症发生率高于肠内营养组(P<0.01)。结论合理应用早期肠内营养支持治疗可改善重症颅脑损伤患者的营养状况,符合生理,减少并发症,改善预后,促进恢复。

Objective To investigate the curative effect of early enteral nutrition support in critically sick patients of severe craniocerebral injury. Methods Sixty-two severe craniocerebral injury patients who could not eat anything in NICU were randomly divided into enteral nutrition group and TPN group. The levels of nutritional status were measured during the period of nutrition support. Results After the second week of nutrition support, the levels of serum total protein （TP） , albumin （ ALB ）, prealbumin（ PALB ） were significandy higher in the two groups than those before the enteral nutrition support（P 〈 0. 01 ）. The levels of TP, ALB and PALB were significantly higher in enteral nutrition group than those in common diet group （ P 〈 0.01 ） . Conclusion The early enteral nutrition support may improve the nutritional condition of severe cranoicerebral injury patients, reduce the incidence rate of complication, and promote the prognosis.